Hacker News Reader

Comment by drivingmenuts | Hacker News Reader

Most healthcare organizations in the US are profit-oriented, sometimes to the detriment of the patients. That is why we have large, unwieldy organizations surrounding the very few people that actually do hands-on healthcare. There’s also the issue of liability – it can be pretty litigious in the US, and companies are frequently wanting to limit their liability, which means having the paperwork to back up their decisions. Unfortunately, it also means they have to restrict their decision-making to a very small matrix.

View on HN

>Most healthcare organizations in the US are profit-oriented

According to the American Hospital Association, less that 20% are for-profit [1]. I'm sure all are extremely budget-conscious, but that's not the same as being profit-driven.

It seems to me that the US optimizes for quality to the detriment of cost and, more recently, access.

[1] https://www.aha.org/statistics/fast-facts-us-hospitals

But also be aware that non-profit does not mean non-profit-oriented. Just that any profit goes to executives [1] instead of toward community/charity services [2].

[1] https://paddockpost.com/2021/06/10/executive-compensation-at... [2] https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.01542

I think there’s an error in conflating “not for profit” with “charity”. You could provide all care at cost and have zero charity care. That d doesn’t imply all “profit” goes to executives, but rather to keep reimbursed or charged costs lower.

1. Thanks for the nuanced view. I agree that zero charity care doesn't necessarily mean greedy execs.

2. In my mind keeping costs lower is a form of charity. Especially with something as frequently difficult to understand as health care costs.

3. Executives do deserve to make a fair amount for their skills and effort. I'm not sure myself what salary I consider it fair pay vs taking greedy advantage of not-for-profit status.

On your last point: I think it's useful to think in multipliers and desired outcomes.

Do you want the best doctors involved in care for patients and training juniors, or do you want them to spend time jockeying for a position in the hierarchy because that's a plausible but also the only way to 2x their income?

This doesn't fully answer the question, of course, but it suggests that large pay disparities are extremely wasteful for society as a whole.

Don’t be fooled by the “non-profit” label. Many are as greedy as for-profit hospitals, except that the money goes to execs and their friends instead of shareholders.

I couldn't find the 20% in your reference, but is it talking specifically about hospitals? I can believe that only 20% of hospitals are for-profit. But, if I do a maps search for all 'healthcare organizations' within 10 miles, the vast majority are for-profit.

Also, of the groups of ambitious hustlers that I know nearby, many are looking to get into running healthcare clinics because there's so much profit to be made.

Reply on news.ycombinator.com